High Tie or not in Resection for Cancer in the Sigmoid Colon?

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Background and Aims: The optimal extent of mesenteric resection in colon cancer surgery remains elusive. The aim was to assess the impact on perioperative morbidity and oncological outcome depending on the height of central vessel ligation in sigmoid resection for adenocarcinomas. Material and Methods: All cases of stage I–III sigmoid cancers, operated on with locally radical resections (2007–2009), were identified in the Swedish Colorectal Cancer Registry and categorized according to the position of the vascular ligature, that is, ligation of the inferior mesenteric artery, ligation of the superior rectal artery, or ligation of the sigmoid branches. Results: In total, 999 cases were identified and possible to categorize. Although higher ligation level yielded a higher number of lymph nodes, 3- or 5-year overall survival, 5-year disease-free survival, or recurrence rate did not differ between the groups (p = 0.79, p = 0.41, p = 0.67, p = 0.51). No differences in survival were detected after multivariate analysis adjusted for age, sex, T-stage, N-stage, American Society of Anesthesiologists classification, and adjuvant therapy. Conclusion: This large population-based study showed increased lymph node yield but no survival benefit or any decreased recurrence rate by high tie in resection of sigmoid cancer.

Original languageEnglish
Pages (from-to)227-232
Number of pages6
JournalScandinavian Journal of Surgery
Issue number3
Early online date2018 Nov 2
Publication statusPublished - 2019 Sept 1

Subject classification (UKÄ)

  • Cancer and Oncology
  • Surgery

Free keywords

  • cancer
  • Colon
  • high tie
  • lymph node
  • surgical technique


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